The daily educational pearl – complications of acute pshychostimulant use

Psychostimulants = broad range of substances that include:

– amphetamines under various forms: amphetamine sulphate or hydrochloride = ‘speed’; methamphetamine tablets = ‘pills’, powder or “base”; crystal methamphetamine = ‘ice’, ‘crystal meth’; dexamphetamine (Ritalin); paramethoxyamphetamine; paramethoxymethamphetamine

– methylenedioxymethamphetamine(MDMA), ‘ecstasy’

– cocaine

– synthetic cannabinoids (e.g. Kronic) – despite the name, toxicity is sometimes similar to amphetamines rather than to cannabis

 

Acute complications of psychostimulant use:

–       agitation, panic states, acute behavioural disturbances

–       psychosis / paranoid delusions / hallucinations

–       hyperthermia

–       seizures (tonico-clonic or myoclonic)

–       haemorrhagic or ischaemic cerebrovascular accidents

–       subarachnoid haemorrhage

–       myocardial ischaemia

–       acute left ventricular failure / acute pulmonary oedema

–       tachyarrhythmias

–       thoracic aortic dissection

–       serotonin syndrome (especially with ecstasy)

–       rhabdomyolysis

–       hyponatraemia / hyperkalaemia / hypoglycaemia

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